垂体脓肿的诊断和治疗(14例报告和文献复习)

目的:探讨垂体脓肿的临床特征和治疗。方法:回顾性分析14例垂体脓肿患者的临床表现、影像学特征、诊断和治疗,并结合文献进行分析。结果:14例患者中头痛13例,垂体功能低下6例,视力视野影响6例,多饮多尿3例,发热3例。MRI增强病灶均呈环状强化。11例经蝶手术治疗,3例经开颅手术。术后随访头痛缓解者10例,视力、视野改善者4例,尿崩者2例恢复正常,垂体功能低下者中4例恢复正常,3例开颅手术者中2例复发,再经蝶手术治愈。结论:应用常规CT和MR术前诊断垂体脓肿困难,对鞍区囊性病变应考虑到垂体脓肿的可能。及早手术、正确选择手术入路、围手术期合理应用抗生素和适当的对症治疗是治疗垂体脓肿的关键。     

Solitary Small Hepatic Angiosarcoma: Initial and Follow-up Imaging Findings

We report an uncommon case of solitary, small hepatic angiosarcoma that was initially considered as a hemangioma. We present the imaging findings, with an emphasis on the initial and follow-up CT and MR findings, as well as report on the more suggestive findings of angiosarcoma than those of a hemangioma.     

Access to primary health care for Australian young people: service provider perspectives.

BACKGROUND: To adequately address the complex health needs of young people, their access to services, and the quality of services received, must be improved. AIMS: To explore the barriers to service provision for young people and to identify the training needs of primary healthcare service providers in New South Wales (NSW), Australia. DESIGN OF STUDY: A cross-sectional, qualitative study of the perspectives of a range of health service providers. SETTING: A range of primary healthcare organisations across NSW. METHODS: Samples of general practitioners (GPs), youth health workers, youth health coordinators, and community health centre staff were drawn from urban and rural clusters across NSW. Focus groups and interviews were used to identify barriers to service provision and the training needs of service providers. Data were tape recorded, transcribed, and analysed. RESULTS: Barriers to service provision among GPs and community health centre staff included inadequate time, flexibility, skills, and confidence in working with young people, and poor linkages with other relevant services. Training needs included better knowledge of and skills in adolescent health requirements, working with adolescents, and working with other services. Barriers to service provision for youth health workers and coordinators included lack of financial resources and infrastructure. There were few linkages between groups of service providers. CONCLUSION: Models of service provision that allow stronger linkages between service providers, sufficient time for consultation with young people, adequate training and support of health professionals, and flexibility of service provision, including outreach, should be explored and evaluated.     

蛋白激酶C激活调控FOS表达参与缺血诱导神经元凋亡的研究

目的：探讨蛋白激酶C（PKC）与神经元凋亡的可能机制，方法：采用大鼠全脑缺血模型，观察脑缺血／再灌流后PKC活性，FOS表达及神经元凋亡的变化。结果：脑缺血／再灌流可以导致PKC的移位激活伴FOS表达及神经元凋亡的增加；用蛋白激酶C抑制剂灯盏花可以阻止上述变化。结论：蛋白激酶C的激活可能通过促进FOS表达参与了脑缺血／再灌流诱导的神经元凋亡。     

Deprivation of form vision suppresses diurnal cycling of retinal levels of leu-enkephalin

Deprivation of form vision by the fitting of translucent occluders suppressed the diurnal cycling of enkephalinergic amacrine cells (the ENSLI amacrine cells), in the chicken. Daily periods of normal vision or enforcing temporal contrast using strobe lighting appeared to restore normal functioning of the ENSLI cells. These results suggest that the ENSLI cells are involved in retinal circuits that assess the quality of the visual image and control eye growth.     

壮骨肾宝对实验性小鼠高脂血症的影响

目的观察由黄芪、白术、淫羊藿组成的复方制剂(壮骨肾宝)对实验性小鼠高脂血症的影响。方法用蛋黄乳液快速致小鼠单纯性高胆固醇血症和喂养高脂饲料致高脂血症模型 ,观察预防性给予不同剂量的壮骨肾宝后对血清总胆固醇(TC)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL -ch)的影响。结果壮骨肾宝中、高剂量能使血清TC降低(P<0.05),HDL -ch升高(P<0.01) ,但对TG的影响不大。结论壮骨肾宝有一定降血脂作用 ,并与剂量有关     

重度磨耗患者髁道运动学初步评价

评价重度磨耗患者后方髁道运动学特征 ,探讨髁状突运动与牙合重建的关系。方法 :运用Pantronic髁状突运动描记系统和D5ADenar全调节式咬合架 ,对 15例中老年重度磨耗患者后方髁道决定因素对牙合运动的影响 ,以及对 5例已完成咬合重建的重度磨耗患者髁道运动学特征进行初步评价。结果 :15例重度磨耗患者平均髁间距离为 ( 60 .72± 4.40 )mm ,迅即侧移量 (ISS) 1.3 5mm (右 )和 1.2 4mm (左 ) ,渐进侧移量 (PSS)为14 .65°(右 )与 17.11°(左 ) ,前伸髁导斜度 (PRO)为 2 3 .45°(右 )与 2 6.85°(左 ) ,非工作侧髁道值 (ORB)为 2 6.5 0° ,前伸髁导斜度与非工作侧髁道之间极相关 ,存在较小的Fisher角。结论 :咬合重建主要影响侧移量和Pantronic重复运动指数 (PRI)的大小 ,反映出下颌侧方边缘运动限制所恢复的程度。但牙合重建对非工作侧髁道没有明显的影响 ,运动道的变化并不能预测治疗的效果。     

THE HISTOLOGIC FEATURES AND HISTOGENESIS OF MALIGNANT OVARIAN BRENNER TUMOR

Eight cases of malignant and 12 0f benign Bren- ner tumor are reported, patient ages ranged 31 69 and 39-53 years. The malignant tumor was bilateral in 6 0f 8 cases, and the benign in l of 12. The greatest diameter of the malignant tumors averaged around 11 cm, and the benign 10. Six of the malignant Brenner tumor patients died, one was lost to follow up, and one survived for 10 years. Pathologic and microscopic findings were pre- sented in some detail. Based on the analysis of the association between the histologic features and type of Mullerian epithelium, we believe that the so called Brenner tumor is in effect a tumor arising from the Mullerian epithelium with a tendency to differentiate into vaginocervical type epithelium.     

复合抗氧化剂对荷瘤大鼠60Co γ射线局部照射时血液氧化损伤的影响

目的探讨荷瘤大鼠60Co γ射线局部照射时血液学氧化损伤以及复合抗氧化剂抗损伤作用. 方法采用Walker-256肿瘤细胞株接种大鼠皮下,得到实体瘤,摘除实体瘤分割成小块植入大鼠的右后腿皮下,制成大鼠荷瘤模型,将荷瘤大鼠分成3组,分别为肿瘤组、照射组和抗氧化剂保护组,同时选取正常大鼠作为阴性对照组. 抗氧化剂保护组每日给予复合抗氧化剂ig,分次对照射组和抗氧化剂保护组的荷瘤大鼠进行60Coγ射线局部照射4次,每次间隔1 wk,累计剂量为47 Gy,最后一次照射后7 d,活杀大鼠,取全血和血清测定过氧化氢酶(CAT)、丙二醛(MDA)、总超氧化物歧化酶(T-SOD)和总蛋白. 结果照射组的MDA含量显著高于非照射组和抗氧化剂保护组(347 μmol*g-1 vs 292, 305和196 μmol*g-1, P<0.05),复合抗氧化剂显示出良好的保护作用. 而照射组的抗氧化酶类如总超氧化物歧化酶(T-SOD)活性显著低于非照射组和抗氧化剂保护组(3.65 μkat*g-1 vs 4.05, 4.82和4.70 μkat*g-1, P<0.05),CAT的活性在照射组显著低于肿瘤组和抗氧化剂保护组(362 K*g-1 vs 677和672 K*g-1, P<0.05). 结论 60Co γ射线局部照射可以产生自由基引发的全身氧化损伤,高效的复合抗氧化剂可以起到有效的保护作用.     

介入手术治疗异位妊娠12例临床分析

目的：探索一种治疗输卵管妊娠的微创介入手术，解决因其腹腔出血不能接受保守治疗或保守治疗失败的难题。保持输卵管完整及通畅，满足有生育需求的患。方法：对12例输卵管妊娠妇女行对侧股动脉穿刺，将导管超选择插至子宫动脉以甲氨喋呤(MTX)进行灌注及明胶海绵栓塞术。结果：本组病例中，术后10dB超复查孕囊脱落、吸收消失，栓塞后盆腔活动性出血停止。结论：介入治疗宫外孕输卵管妊娠，能有效杀灭胚胎组织，栓塞破裂血管止血效果明显，且能保持输卵管通畅。